The use of endoscopic surgical procedures has become increasingly accepted throughout the surgical community. There are many advantages associated with the use of endoscopic surgical techniques including improved post-operative recuperation, decreased avenues for infection, and decreased post-operative hospital stays. The term endoscopic as used herein is meant to encompass all minimally invasive surgical techniques utilizing a scope including endoscopic, laparoscopic, thoracoscopic and arthroscopic.
In many endoscopic surgical techniques, it is necessary to enter a body cavity to obtain access to a target surgical site. This is conventionally done by using a conventional trocar. A trocar typically consists of a trocar obturator having a sharp piercing point and a trocar cannula. The trocar obturator is concentrically housed within the trocar cannula during insertion through the musculature and fascia surrounding the body cavity. The trocar obturator is then removed from the trocar cannula after the trocar has been maneuvered into the body cavity, leaving the trocar cannula as a pathway into the body cavity, e.g., the abdomen.
Numerous surgical instruments have been developed and adapted for endoscopic surgical techniques. For example, there are stapling apparatuses, suture and cannula assemblies, electrocautery devices, tissue manipulating devices, tissue cutting devices, tissue ligating devices, and the like. Frequently, it is necessary for the surgeon to manipulate or move internal organs such as the liver, the spleen, and the gall bladder in order to access the target surgical site. This is typically done with a variety of tissue manipulators which have been specially developed for this task.
In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to remove tissue or damaged organs. This is especially challenging during endoscopic surgery because of the small openings (i.e., trocar cannulas) through which such tissue or organs must be removed. Under these circumstances, it may be necessary to fragment, or morcellate, the tissue so that it can be readily removed through the small endoscopic openings.
In response to the need to morcellate and remove tissue during endoscopic surgery, tissue morcellators have been developed to aid the surgeon. The tissue morcellators rapidly cut tissue into a plurality of fine particles. In other endoscopic surgical procedures, it is often necessary or desired to enclose a fractured organ during surgical repair to aid the surgeon in maintaining the integrity of the bodily organ.
U.S. Pat. No. 5,143,082 discloses a surgical device for enclosing body tissue or internal organs. The device consists of a plastic pouch having a cinch and loop which is mounted to the distal end of a cannula. The pouch is folded about the cannula and mounted in an introducer which is inserted through a conventional cannula into a body cavity during an endoscopic procedure. The pouch is unfurled in the body cavity. After body tissue has been placed in the cavity, the open end of the pouch is cinched closed and the tissue, bag and cannula are removed from the body cavity.
Conventional surgical pouches or bags for use in endoscopic procedures are typically made from plastic and shipped in a folded or rolled configuration (within an introducer) so that the surgeon may insert the pouch through a cannula without having to interrupt surgery to fold or roll the pouch during the operative procedure. It is known that most plastics when folded or rolled take a set. The effect of a "set" is to prevent the pouch from unfurling or unfolding and attaining a substantially flat configuration similar to that which it had prior to rolling or folding. It is preferred in an endoscopic procedure that the pouch have a substantially flat configuration to permit easy tissue insertion. It is often necessary to use a second endoscopic instrument to unfurl the pouch. This is not only time consuming, but requires the use of a second trocar cannula and at least one grasping instrument to maintain the pouch in a substantially flat configuration. Another deficiency which has been observed with conventional plastic pouches is that the mouth (or opening) of the pouch may be difficult to open in a body cavity, particularly when it becomes moist from body fluids. It is believed that the surface tension of the moisture in contact with the plastic of the pouch causes the mouth of the pouch to resist opening. Even when the mouth is dry, it often may be necessary to force it open by inserting an additional instrument into the mouth of the pouch and manipulating it to the full open position. After opening, difficulties with tissue insertion can develop because the mouth may re-close. When the mouth of the pouch becomes wet with body fluids, it is even more difficult to open the pouch because, it is believed, of the forces resulting from the surface tension of the fluids.
There is a need in this art for endosurgical pouches which unfold or unfurl automatically when inside of a mammalian body. There is also a need for endosurgical pouches which have mouths which open automatically when inside of a mammalian body.